TRACI CALDWELL
Little Rock,AR
Summary
Billing Manager and Insurance Claims Specialist with extensive experience in medical coding, accounts receivable management, and compliance. Proven track record in resolving billing issues, training staff, and improving cash flow. Expertise in ICD-10-CM, CPT, and HCPCS codes, enhancing operational efficiency and client satisfaction. Veteran Billing Manager focused on team efficiency and producing high-quality work. Excellent collaborator and relationship-builder familiar with compliance and documentation requirements. Enthusiastic about taking billing operations to the next level through proactive leadership and skilled problem solving. Hardworking and passionate job seeker with strong organizational skills eager to secure Coding and Billing position. Ready to help team achieve company goals.
Overview
23
23
years of professional experience
1
1
Certification
Work History
BILLING MANAGER, CPC,CPB,NOTARY
Neurological Surgery Associates
06.2021 - Current
- Reviewed billing problems, researched issues, and resolved concerns.
- Managed monthly billing process to complete billings and returns to meet company revenue recognition policies.
- Trained and mentored staff on procedures, compliance requirements, and collections techniques.
- Collaborated with cross-functional teams to resolve billing-related issues swiftly, minimizing negative impacts on overall operations.
- Implemented policies that improved accounts receivable collections, resulting in reduced outstanding balances and increased cash flow.
- Worked with customers to develop payment plans and bring accounts current.
- Developed comprehensive training materials for new hires to quickly acclimate them to company procedures and software systems.
- Conducted periodic reviews of existing processes to identify areas of potential cost savings or efficiency improvements.
- Maintained up-to-date knowledge of industry regulations and compliance requirements, ensuring the department remained compliant at all times.
- Achieved significant cost savings by identifying and eliminating inefficiencies in billing process, reallocating resources to areas of higher impact.
- Enhanced customer service, resolving billing disputes swiftly and maintaining positive relationships with clients.
- Established and checked coding procedures, monitored reports and updated internal files.
- Performed banking, business administration and financial tasks to guarantee five-star service for clients.
- Managed online and mobile acquisition programs with focus on CPA, CPI and CPC.
- Ensured compliance with relevant regulations by staying current on updates related to ICD-10-CM/PCS guidelines, CPT codes, HCPCS Level II codes, modifiers usage rules.
- Reduced claim denials by accurately coding diagnoses and procedures using ICD-10, CPT, and HCPCS codes.
- Confirmed appointments, communicated with clients, and updated client records.
- Answered phone promptly and directed incoming calls to correct offices.
- Responded to inquiries from callers seeking information.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Collaborated with healthcare providers to gather necessary information for accurate credentialing decisions.
- Managed multiple priorities effectively, resulting in the on-time completion of credentialing tasks for numerous providers simultaneously.
- Enrolled providers and Medicaid, Medicare, and private insurance plans.
- Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
- Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
- Assisted in the recruitment process, conducting interviews and onboarding new employees to promote a seamless integration into the team dynamic.
- Maintained office PCs, networks and mobile devices.
- Provided remote technical support, resolving issues quickly without requiring onsite visits whenever possible.
- Collaborated with healthcare providers to ensure accurate and complete referral information, improving patient care coordination.
- Improved turnaround times for lien filings by optimizing internal processes and utilizing technology solutions effectively.
CPC
MEDEVOLVE
10.2017 - 03.2021
- Managed online and mobile acquisition programs with focus on CPA, CPI and CPC.
- Demonstrated expertise in various code sets including CPT, HCPCS Level II, ICD-10-CM/PCS codes while maintaining certification as an Inpatient Coder.
- Reduced claim denials by accurately coding diagnoses and procedures using ICD-10, CPT, and HCPCS codes.
- Reviewed out-patient medical documents of diagnosis and procedures and assigned ICD-10, CPT, and HCPCS according to coding guidelines.
- Evaluated and settled complex insurance claims in strict timeframes.
- Generated, posted and attached information to claim files.
- Posted payments to accounts and maintained records.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
CPC
MEDICAL OFFICE SYSTEMS
12.2016 - 10.2017
- Managed online and mobile acquisition programs with focus on CPA, CPI and CPC.
- Demonstrated expertise in various code sets including CPT, HCPCS Level II, ICD-10-CM/PCS codes while maintaining certification as an Inpatient Coder.
- Reduced claim denials by accurately coding diagnoses and procedures using ICD-10, CPT, and HCPCS codes.
- Reviewed out-patient medical documents of diagnosis and procedures and assigned ICD-10, CPT, and HCPCS according to coding guidelines.
- Served as an expert resource for colleagues on medical coding systems such as ICD-10, CPT, and HCPCS Level II coding conventions.
- Continuously improved expertise in ICD-10-CM, CPT, and HCPCS codes through ongoing professional development courses and certifications.
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Strengthened client relationships by providing clear communication throughout the claims process, ensuring all parties were well-informed of progress and outcomes.
- Evaluated and settled complex insurance claims in strict timeframes.
Insurance Claims Specialist, Medical Coder
PRACTICE PLUS
06.2009 - 10.2015
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Strengthened client relationships by providing clear communication throughout the claims process, ensuring all parties were well-informed of progress and outcomes.
- Evaluated and settled complex insurance claims in strict timeframes.
- Managed online and mobile acquisition programs with focus on CPA, CPI and CPC.
- Ensured compliance with relevant regulations by staying current on updates related to ICD-10-CM/PCS guidelines, CPT codes, HCPCS Level II codes, modifiers usage rules.
- Reduced claim denials by accurately coding diagnoses and procedures using ICD-10, CPT, and HCPCS codes.
- Trained new hires in company policies, standard operating procedures, and software systems related to accounts receivable functions, ensuring seamless integration into the team''s operations.
- Maintained accurate and complete records to document transactions and support decision-making.
- Performed daily bank reconciliations, detecting and resolving discrepancies between bank statements and company records.
Insurance Claims Specialist, Medical Coder
Arkansas Cardiology
05.2008 - 05.2009
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Strengthened client relationships by providing clear communication throughout the claims process, ensuring all parties were well-informed of progress and outcomes.
- Evaluated and settled complex insurance claims in strict timeframes.
- Followed up with customers on unresolved issues.
- Managed online and mobile acquisition programs with focus on CPA, CPI and CPC.
- Ensured compliance with relevant regulations by staying current on updates related to ICD-10-CM/PCS guidelines, CPT codes, HCPCS Level II codes, modifiers usage rules.
- Reduced claim denials by accurately coding diagnoses and procedures using ICD-10, CPT, and HCPCS codes.
Accounts Receivable Clerk
St. Vincent Family Clinic
01.2002 - 10.2007
- Prepared and mailed invoices to customers, processed payments, and documented account updates.
- Submitted cash and check deposits and generated cash receipts to record money received.
- Maintained up-to-date customer contact information, enabling effective communication regarding account status and payment inquiries.
- Prepared billing statements and invoices for customer purchases and recorded transaction date, price and fees to support accuracy.
- Contributed to month-end closing procedures by preparing detailed accounts receivable aging reports for management review.
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Strengthened client relationships by providing clear communication throughout the claims process, ensuring all parties were well-informed of progress and outcomes.
- Evaluated and settled complex insurance claims in strict timeframes.
- Managed online and mobile acquisition programs with focus on CPA, CPI and CPC.
- Ensured compliance with relevant regulations by staying current on updates related to ICD-10-CM/PCS guidelines, CPT codes, HCPCS Level II codes, modifiers usage rules.
- Reduced claim denials by accurately coding diagnoses and procedures using ICD-10, CPT, and HCPCS codes.
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Confirmed appointments, communicated with clients, and updated client records.
- Resolved customer problems and complaints.
- Streamlined front desk operations for increased efficiency by effectively managing phone calls, emails, and walk-in clients.
Education
High School Diploma -
Mcqueen High School
Reno, NV06.1999
Skills
- Personnel Oversight
- Audit Support
- Accounts receivable management
- Interest calculations
- HIPAA knowledge
- Collections experience
- Claims Processing
- Training and mentoring
- Staff Training and Development
- Insurance Verification
- Denial Management
- Medical Billing Expertise
- Invoice Processing
- Collections understanding
- Revenue Cycle Management
- Payment posting
- Multitasking
- Reliability
- Organizational Skills
- Accounting management
- Financial Reporting
Certification
- Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC).
- Specialty Coding Professional – Advanced Neurology & Neurosurgery Coding
- Notary Public License - Arkansas Secretary of State or equivalent authority.
Timeline
BILLING MANAGER, CPC,CPB,NOTARY
Neurological Surgery Associates
06.2021 - Current
CPC
MEDEVOLVE
10.2017 - 03.2021
CPC
MEDICAL OFFICE SYSTEMS
12.2016 - 10.2017
Insurance Claims Specialist, Medical Coder
PRACTICE PLUS
06.2009 - 10.2015
Insurance Claims Specialist, Medical Coder
Arkansas Cardiology
05.2008 - 05.2009
Accounts Receivable Clerk
St. Vincent Family Clinic
01.2002 - 10.2007
High School Diploma -
Mcqueen High School
- Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC).
- Specialty Coding Professional – Advanced Neurology & Neurosurgery Coding
- Notary Public License - Arkansas Secretary of State or equivalent authority.
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